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A Longitudinal Analysis of Cardiovascular Conditions and Related Comorbidities Among Human Immunodeficiency Virus (HIV) Patients in the USA
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Reported by Jules Levin
IDSA 2015 Oct 7-11 San Diego, CA
Priscilla Hsue1, Nicole Meyer2, Xue Song2 and Jonathan Winston3
1UCSF, CA, USA; 2Truven Health Analytics, MD, USA; 3Mount Sinai, NY, USA
- A total of 31,229 HIV patients (mean age: 42.8; male: 77.9%)
- The most common comorbidities were hypertension (Commercial: 32.5%; Medicare: 77.0%; Medicaid: 55.5%), hyperlipidemia (30.6%, 52.7%, 33.8%), diabetes (11.2%, 36.9%, 25.1%), renal impairment (8.3%, 34.6%, 19.1%), and CVD (6.4%, 34.4%, 15.5%). Rates of comorbidities were higher in 2013 than in 2007. CVD prevalence rose over time (Figure) from 2007-2013. Among CVD patients, mean number of MI hospitalizations in 2013 were 1.1, 1.0 and 1.0 in Commercial, Medicare, and Medicaid, respectively. MI prevalence in 2013 was 18.9, 77.8, and 37.0 for Commercial, Medicare, and Medicaid.
- Overall Clinical Characteristics in 2007-2013: The most common comorbidities/CV risk factors were hypertension (Commercial: 32.5%; Medicaid: 55.5%; Medicare: 77.0%), hyperlipidemia (30.6%, 33.8%, 52.7%), diabetes (11.2%, 25.1%, 36.9%), renal impairment (8.3%, 19.1%, 34.6%), and CV disease (6.4%, 15.5%, 34.4%). [12.6% HCV in Medicaid]
- In the time period 2007-2013, CV event prevalence (per 1,000 patients) was 70.2 in Commercial patients, 174.5 in Medicaid, and 377.0 in Medicare. CV event incidence (per 1,000 patient-years) was 18.4 in Commercial, 41.6 in Medicaid, and 93.1 in Medicare, respectively.
- Unique CV Risk Factors Among 2013 Prevalent HIV Patients: Among the prevalent HIV patients in 2013, Medicare had the highest percentage of
patients with one or more CV risk factors (81.4%) followed by Medicaid (61%) and then Commercial (41.3%). (Figure 3)
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